Hospital-acquired infections due to multidrug-resistant bacteria are a major cause of increased morbidity and mortality in patients with weakened immunity. A leading agent of such infections is the bacterium Acinetobacter baumannii. This microbe causes invasive infections, including pneumonia and sepsis, that in recent years have become increasingly severe and antibiotic-resistant, raising the specter that they may one day be untreatable. New ways to prevent and treat infections with A. baumannii are urgently needed, but alarmingly little is known about how these bacteria cause disease. Recent evidence indicates that these bacteria induce adherence-dependent cytotoxicity toward cultured epithelial cells; however, the mechanisms used by A. baumannii to intoxicate cells upon adhesion are unclear. The goal of the proposed studies is to understand how these microbes interact with human cells and how such interactions undermine normal cellular processes, promoting infection. Towards this goal, this proposal aims to characterize in detail a contact-dependent protein delivery system, known as a Type VI Secretion System (T6SS) that is present in clinical strains of A. baumannii responsible for recent epidemics. These systems play a role in host infections by a range of microbes, but the system is undefined in A. baumannii. The proposed work will determine which cells are targeted by the A. baumannii T6SS, identify the effector proteins it sends into these cells, and examine the functional roles of the system and its effectors in host interactions and pathogenesis. These aims will be accomplished by analyzing the transfer of reporter fusions into target cells, conducting directed genome-wide screens for effectors, and examining the effects of T6SS- and effector-null mutants on bacterial toxicity and the host innate immune response during interactions with host cells in culture and in a murine model of pneumonia. These studies will break new ground on the mechanisms used by A. baumannii to promote infection and will address key gaps in our understanding of T6SS pathobiology. Ultimately, this information will uncover targets for novel anti-infective treatments and vaccines against highly drug- resistant bacteria. The training experience will broaden my expertise in molecular biology, teach me new techniques in mammalian cell culture and animal models, and advance my understanding of the pathogenesis of infectious diseases. PUBLIC HEALTH RELEVANCE: Acinetobacter baumannii, a frequent cause of invasive, hospital-acquired infections, has become more drug resistant and aggressive in recent years. The proposed research is aimed at understanding how the bacterium interacts with cells within the infected host in a way that promotes bacterial growth and misregulation of host cells. This knowledge will expose potential targets for novel anti-infective therapeutics against these highly resistant microbes.!